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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2018; 79(01): e9-e13
DOI: 10.1055/s-0038-1635098
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Combined Open and Endoscopic Endonasal Skull Base Resection of a Rare Endometrial Carcinoma Metastasis

Melissa M. Stamates
1   Section of Neurosurgery, University of Chicago, Chicago, Illinois, United States
,
John M. Lee
2   Department of Pathology and Laboratory Medicine, NorthShore University Health System, Evanston, Illinois, United States
,
Ryan T. Merrell
3   Department of Neurology, NorthShore University Health System, Evanston, Illinois, United States
,
Michael J. Shinners
4   Department of Otolaryngology, NorthShore University Health System, Evanston, Illinois, United States
,
Ricky H. Wong
5   Department of Neurosurgery, NorthShore University Health System, Evanston, Illinois, United States
› Author Affiliations
Further Information

Publication History

02 October 2017

12 January 2018

Publication Date:
22 February 2018 (online)

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Abstract

In the absence of significant extracranial disease, patients with solitary brain metastases have shown benefit with resection. Brain lesions due to endometrial cancer are uncommon, and the only described skull base involvement is limited to the pituitary gland. We report the case of a 60-year-old female with endometrial cancer who presented with weeks of right cheek pain and numbness that was accompanied by headaches. We describe the magnetic resonance imaging (MRI) findings and surgical resection of a solitary endometrial metastasis involving the infratemporal fossa, middle fossa, cavernous sinus, trigeminal nerve, and nasal sinuses. Due to extensive nasal and lateral involvement, a combined open and endoscopic approach was planned. The patient was discharged home without complication. She underwent adjuvant radiotherapy. Despite its suspected indolent course, intracranial endometrial adenocarcinoma metastases are gaining higher prevalence. This case report documents the first direct neural spread of an endometrial primary, and highlights the potential for extra-axial sites of metastasis.

Keywords

skull base metastasis - endometrial carcinoma - endoscopic endonasal approach - neuro-oncology - anatomic pathology - middle fossa lesion

Disclosures

The authors report no conflict of interest concerning the materials or methods used or the findings specified in this paper.


 

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